Form 19

Summons in relation to breach of psychiatric probation order or program probation order

In force

Commonwealth of Australia

Crimes Act 1914

SUMMONS UNDER PARAGRAPH 20BW(1)(a)

IN THE ¹

AT ²

IN THE *STATE OF ³

⁴(Informant)

‑and‑

⁵(Defendant)

To: ⁶

You are summoned under paragraph 20BW(1)(a) of the Crimes Act 1914 to appear before the ⁷ at ⁸at ⁹ to answer the information alleging the breach of the following *condition/*conditions of the order under section *20BV/*20BY of that Act:

(a)

¹⁰;

(b)

¹⁰;

and to be further dealt with according to law.

Dated ¹¹.

¹²

¹³

¹ insert name of court

² insert location of court

³ insert State or Territory

⁴ insert name of informant

⁵ insert name of defendant

⁶ insert name of person

⁷ insert name of court

⁸ insert address of court

⁹ insert time and date

¹⁰ list details of alleged breaches of conditions

¹¹ insert date

¹² signature of magistrate

¹³ designation of magistrate

* omit if inapplicable

This Act’s bill:Explanatory statement

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